EAACI Biologicals Guidelines—Omalizumab for the treatment of chronic spontaneous urticaria in adults and in the paediatric population 12–17 years old

• Published in: Allergy (Copenhagen) Vol. 77; no. 1; pp. 17 - 38
• Main Authors: Agache, Ioana, Akdis, Cezmi A., Akdis, Mubeccel, Brockow, Knut, Chivato, Tomas, Giacco, Stefano, Eiwegger, Thomas, Eyerich, Kilian, Giménez‐Arnau, Ana, Gutermuth, Jan, Guttman‐Yassky, Emma, Maurer, Marcus, Ogg, Graham, Ong, Peck Y., O’Mahony, Liam, Schwarze, Jürgen, Warner, Amena, Werfel, Thomas, Palomares, Oscar, Jutel, Marek
• Format: Journal Article
• Language: English
• Published: Denmark Blackwell Publishing Ltd 01.01.2022
• Subjects: Adolescent; Adult; Adults; Anti-Allergic Agents - therapeutic use; Antihistamines; Biological products; Biological Products - therapeutic use; Child; Chronic Disease; chronic spontaneous urticaria; Chronic Urticaria; GRADE; guidelines; Humans; Immunoglobulin E; Monoclonal antibodies; omalizumab; Omalizumab - therapeutic use; Pediatrics; Teenagers; Treatment Outcome; Urticaria; Urticaria - drug therapy; GRADE; guidelines; omalizumab; chronic spontaneous urticaria
• ISSN: 0105-4538; 1398-9995
• DOI: 10.1111/all.15030

Chronic spontaneous urticaria (CSU) imposes a significant burden on patients, families and healthcare systems. Management is difficult, due to disease heterogeneity and insufficient efficacy of classical drugs such as H1R‐antihistamines. Better understanding of the mechanisms has enabled a stratified approach to the management of CSU, supporting the use of targeted treatment with omalizumab. However, many practical issues including selection of responders, the definition of response, strategies to enhance the responder rate, the duration of treatment and its regimen (in the clinic or home‐based) and its cost‐effectiveness still require further clarification. The EAACI Guidelines on the use of omalizumab in CSU follow the GRADE approach in formulating recommendations for each outcome. In addition, future therapeutic approaches and perspectives as well as research priorities are discussed.